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W <br />City of Everett <br />Sewer Application and Permit <br />NO. 24042 <br />Service <br />Billing <br />City, S <br />Owner <br />Billing <br />Conne <br />Add <br />DATE <br />DESCRIPTION: <br />Lot 3— °Zc Blo t� <br />Plat = <br />Unplatted Description <br />SEE SKETCH ATTACHED <br />CHART <br />Po� E-D <br />Utility Account No. S <br />Permit Fee 1�z �J <br />Connection Charge(s)� <br />Total Fee <br />Signed <br />Cussomer <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Abutting Lot Line <br />N,S,E,W <br />Approved B� <br />/Q it Eng% er <br />3 <br />Issued By <br />Inspection <br />Date Inspe <br />ND. 24042 <br />INSPECTION I' <br />